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nurs 345: children > ch 29: communication & physical assessment > Flashcards

ch 29: communication & physical assessment Flashcards

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1
Q

before even starting the interview, what should you do?

A

establish a setting
- introduction
- assure privacy & confidentiality

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2
Q

how should you communicate with families?

A
  • encourage them to talk to their kid & what they want
  • direct focus
  • listen & cultural awareness
  • using silence
  • empathy
  • guidance
  • avoid blocks of communication
  • use an interpreter if needed
  • talk about the different developmental processes
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3
Q

what should you as the nurse control about yourself?

A

know your weaknesses
- control your face
- dont be overwhelming
- self awareness

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4
Q

what are some communication techniques?

A
  • verbal & non verbal
  • play
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5
Q

how should you take history?

A
  • identify info
  • know the chief complaint
  • if there is a present illness –> OLD CARTS
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6
Q

what should you jot down when taking past medical history for the child?

A
  • birth hx
  • any previous illness, injuries & operations
  • allergies
  • current medications
  • immunizations
  • diet hx
  • habits
  • growth & development!!
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7
Q

how should you approach the interview? what is important before asking questions?

A
  • explain what you are doing
  • let them get comfortable
  • ask open ended questions
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8
Q

how do you make an infant comfortable for the interview?

A

ask questions to the parents first, let the infant get used to their environment

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9
Q

how do you let a preschooler get comfortable before the interview?

A

play with them first

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10
Q

how do you let an adolescent get comfortable?

A

talk to them right away

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11
Q

what is the process of the interview (in steps)?

A
  1. introduce yourself
  2. get to know them
  3. explain what you are doing
  4. ask about what they are here for (if pain –> OLD CARTS)
  5. neuro
  6. cardiovascular
  7. respiratory
  8. GI
  9. GU
  10. musculoskeletal
  11. skin
  12. sexual history & more private questions
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12
Q

after assessing the skin in the interview, how old should the patient be to know if you want to ask about sexual history?

A

13 years old

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13
Q

what should you do before asking about more personal questions and their sexual history?

A

ask the parents to step out of the room

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14
Q

what are the interviewing steps for sexual history & more private questions?

A
  1. ask the parent to step out
  2. explain that the information is confidential except for suicide & homicide
  3. aks about depression, anxiety & suicide
  4. ask about intercourse
  5. sexual orientation
  6. ask if they have a trusted adult they can go to
  7. education
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15
Q

what should you jot down for family health history?

A
  • geographic location: can understand different diseases based on loco
  • family structure
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16
Q

what should you assess for nutrition in the child?

A
  • diet intake
  • hair, skin, mouth, & eyes
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17
Q

what are the results/evaluation choices after assessing the nutrition of the child?

A
  • malnourished
  • at risk
  • well nourished
  • overweight or obese
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18
Q

what are some challenges to examining a child?

A

they can be reluctant & have trantrums

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19
Q

how should we approach examining of the child?

A

most comfortable first –> least comfortable last

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20
Q

what is the most uncomfortable to children?

A

eyes, ears & mouth

21
Q

what are the goals to a pediatric assessment?

A
  • minimize stress & anxiety
  • foster trust
  • maximum preparation
  • preserve security of parent & child
  • maximize accuracy
22
Q

what are the assessment goals of an infant?

A

make these a priority when they are calm
- RR
- HR
- bowel sounds

23
Q

how should we prepare a child for an assessment?

A
  • cooperation enhanced with parents
  • age appropriate techniques
  • positioning
24
Q

what are some age appropriate techniques?

A
  • dolls & teddy bears
  • parents present
  • videos
  • demonstration
25
Q

what is prioritized in a physical exam?

A

growth measurements
- length
- height
- weight

circumference measures
- skin thickness
- arm circumference
- head circumference

26
Q

how should we approach the physical exam in school age kids?

A

make it like a game – they want to see how strong they are

27
Q

how do growth curves track development of a child?

A

the body grows during homeostasis
- if child is dropping off –> a sign that something is wrong
- endocrine or medical problems

28
Q

what should we jot down for physiological measurements and what goes first?

A

respiratory is always first then
- temperature
- pulse: radial, brachial, or apical

29
Q

what area is prefered to get a pulse on a child?

A

apical

30
Q

how long should you count for RR & HR and why?

A

60 seconds – to get a full accurate count

31
Q

where are areas can you put the BP cuff?

A
  • brachial artery
  • radial artery
  • popliteal artery
  • dorsalis pedis artery
  • posterior tibial artery
32
Q

when do posterior cranial sutures close for infants?

A

2 months

33
Q

when do anterior cranial sutures close for infants?

A

12-18 months

34
Q

do we always assess the cranial nerves?

A

no, only for specific neuro exams

35
Q

what is the eye chart called for younger kids?

A

allen figures chart

36
Q

why aren’t we really worried ab an infant’s vision?

A
  • can only see mom’s face – they should be able to follow mom’s face with their eyes
  • vision is still developing
36
Q

when assessing the internal structures of the ear, what age do we pull the pinna down and back?

A

less than 2 years old

36
Q

when assessing the internal structures of the ear, what age do we pull the pinna up and back?

A

2 yo and older

36
Q

what should we assess about the nose?

A
  • sides
  • nares
  • patency
  • any drainage
  • how does it fit with the rest of their face?
36
Q

what should we be aware about the chest?

A

one side can be lower then the other

37
Q

what is something we need to get used to when auscultating the lungs?

A

hearing the heart & lungs simultaneously

38
Q

Should we worry about heart murmurs when we heart them in kids?

A

not really, some kids grow out of it

39
Q

how should we auscultate the heart?

A

APE To Man

40
Q

what should we look out for when assessing genitalia?

A

swelling

41
Q

what should we look out for when assessing the anus?

A
  • patency
  • are they pooping?
42
Q

describe genu valgum

A

when the kids knees are stuck together like gum

43
Q

describe genu varum

A

when the knees are spread apart like a bottle of rum is between them

44
Q

which is more normal, genu valgum or genu varum?

A

genu varum, “bow leg”

45
Q

when is genu valgum and genu varum considered a problem?

A

when their legs are still like that by the age of 2yo +

nurs 345: children (23 decks)

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